Schumacher Jessica R, Tucholka Jennifer L, Breuer Catherine R, McKinney Grace H, Maxcy Courtney, Stankowski-Drengler Trista J, Marka Nicholas A, Hanlon Bret M, Kwekkeboom Kristine L, Tevaarwerk Amye J, Haine James E, Neuman Heather B
Department of Surgery, School of Medicine and Public Health, Wisconsin Surgical Outcomes Research Program, University of Wisconsin, Madison, WI, USA.
University of Wisconsin Carbone Cancer Center, Madison, WI, USA.
Ann Surg Oncol. 2025 May;32(5):3252-3259. doi: 10.1245/s10434-025-16959-w. Epub 2025 Jan 29.
Little is known about the symptom burden of breast cancer survivors with early-stage disease. Many studies have focused on symptoms of patients who are undergoing or recently completed systemic therapy. However, with the increased use of Oncotype DX, the proportion of early-stage hormone receptor-positive patients who undergo chemotherapy has declined, making existing studies of the symptom experience less useful for these patients.
The aim of this study was to assess symptom burden for early-stage breast cancer survivors.
Eligible survivors had stage I-II, estrogen receptor (ER)- or progesterone receptor (PR)-positive and HER2neu-negative breast cancer, did not receive chemotherapy, were 6 months-5 years post-diagnosis, and were cancer-free. Survivors were enrolled at the University of Wisconsin Breast Center follow-up visits and were emailed a link to a patient-reported outcomes (PRO) survey. Survey domains were informed by American Cancer Society/American Society of Clinical Oncology (ACS/ASCO) survivorship guidelines and survivor/provider stakeholders. The prevalence of clinically significant symptoms are reported.
Overall, 98 patients participated. On average, participants were 61.3 years of age (standard deviation [SD] 11.5) and 2.5 years post-diagnosis (SD 1.2); 71.3% underwent breast-conserving surgery. The average item-level missingness rate was low (2.0%). Most survivors (86.2%) experienced symptoms (38.8% reporting one to two symptoms; 47.9% reporting more than three symptoms).
Early-stage breast cancer survivors report a high symptom burden. Given nearly 50% of survivors report more than three symptoms, many topics may not be discussed or addressed during time-limited follow-up visits. Some symptoms, such as sexual health, may be less feasible to address in-clinic given their complex/sensitive nature. Use of PROs allows for a comprehensive evaluation and identification of unrecognized needs, representing an opportunity to improve survivorship care.
对于早期乳腺癌幸存者的症状负担，我们了解甚少。许多研究都聚焦于正在接受或刚完成全身治疗的患者的症状。然而，随着Oncotype DX检测的使用增加，接受化疗的早期激素受体阳性患者比例有所下降，使得现有的症状体验研究对这些患者的实用性降低。
本研究旨在评估早期乳腺癌幸存者的症状负担。
符合条件的幸存者患有I-II期、雌激素受体（ER）或孕激素受体（PR）阳性且HER2neu阴性的乳腺癌，未接受化疗，诊断后6个月至5年，且无癌症。幸存者在威斯康星大学乳腺中心随访就诊时登记，并通过电子邮件收到患者报告结局（PRO）调查的链接。调查领域依据美国癌症协会/美国临床肿瘤学会（ACS/ASCO）生存指南以及幸存者/医疗服务提供者利益相关者的意见确定。报告了具有临床意义症状的患病率。
总体而言，98名患者参与。参与者平均年龄为61.3岁（标准差[SD] 11.5），诊断后2.5年（SD 1.2）；71.3%接受了保乳手术。平均项目缺失率较低（2.0%）。大多数幸存者（86.2%）经历了症状（38.8%报告一至两种症状；47.9%报告三种以上症状）。
早期乳腺癌幸存者报告的症状负担较高。鉴于近50%的幸存者报告三种以上症状，在限时随访就诊期间，许多话题可能未被讨论或提及。一些症状，如性健康，鉴于其复杂/敏感的性质，在临床中可能较难处理。使用PROs可进行全面评估并识别未被认识到的需求，这是改善生存护理的一个契机。
